Acute Myocardical Infarction with ST Elevation (STEMI), Direct PCI, Times and Lethality

In ST-segment elevation myocardial infarction (STEMI), rapid revascularization is of paramount importance, and direct transport to a percutaneous coronary intervention (PCI)-capable center is recommended. Long-term follow-up data comparing both approaches are scarce. The purpose of this study was to compare the long-term outcomes of direct primary transfer (PT) and indirect secondary transfer (ST) in patients with STEMI. Method and study group: We enrolled consecutive patients referred for STEMI within 12 h of symptom onset. The primary endpoint was to compare long-term lethality of direct PT and indirect ST in patients with STEMI. During a two-year period (2008-2009), we prospectively recorded lethality and the door-to-balloon time (DBT) of 869 patients with STEMI from arrival at the first hospital until reperfusion by PCI in the catheterization laboratory. A total of 677 patients (77.9%) were enrolled for the final evaluation, with 192 (22.1%) patients excluded. We divided the patients into two groups: the first group (PT) had been transferred directly from the field to a catheterization laboratory, while the second group (ST) had been transferred from regional hospitals to a catheterization laboratory. The final analysis included 677 patients aged 20 to 96 years; the mean age was 64,04 years,..